Appendix B: TRAINING and CONSENT

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Appendix B: TRAINING AND CONSENT

Individualized Plan and Emergency Procedures for a Child with an Anaphylactic Allergy

I Click here to enter text. (parent/guardian) hereby confirm that:

(a)I have trained the person(s) named in the Trainee Confirmation below (Table 1) on my child’s Individualized Plan and Emergency Procedures on Click here to enter text. (date), and

(b)I give consent to the person(s) named in the Trainee Confirmation (Table 1) below to train any other staff, students and volunteers (Table 2) who may be interacting with my child to perform the procedures detailed in my child’s Individualized Plan and Emergency Procedures.

Parent/Guardian Full Name: Click here to enter text.

Parent/Guardian Signature: ______

Date (yyyy/mm/dd): Click here to enter text.

Table 1: Trainee Confirmation

Name of Trainee / Position / Signature of Trainee: / Date Training Received (dd/mm/yyyy): / Date Signed (dd/mm/yyyy):
Click here to enter text. / Click here to enter text. / Click here to enter text. / Click here to enter text. /
Click here to enter text. / Click here to enter text. / Click here to enter text. / Click here to enter text.
<add rows as needed>

Table 2: Training Log for Staff, Students, and Volunteers

Name of Individual / Position / Signature of Individual: / Date Training Received (dd/mm/yyyy): / Date Signed (dd/mm/yyyy):
Click here to enter text. / Click here to enter text. / Click here to enter text. / Click here to enter text. /
Click here to enter text. / Click here to enter text. / Click here to enter text. / Click here to enter text.<add rows as needed>

Comments (e.g. names of individuals who have not yet been trained, reason(s) and next steps):

Click here to enter text.

Disclaimer: This document is a sample template that has been prepared to assist licensees in understanding their obligations under the CCEYA and O. Reg. 137/15. It is the responsibility of the licensee to ensure that the information included in this document is appropriately modified to reflect the individual circumstances and needs of each child care centre it operates.

Please be advised that this document does not constitute legal advice and should not be relied on as such.The information provided in this document does not impact the Ministry’s authority to enforce the CCEYA and its regulations. Ministry staff will continue to enforce such legislation based on the facts as they may find them at the time of any inspection or investigation.

It is the responsibility of the licensee to ensure compliance with all applicable legislation. If the licensee requires assistance with respect to the interpretation of the legislation and its application, the licensee may wish to consult legal counsel.